Holmium Laser Treatment for Low Grade, Low Stage, Noninvasive Bladder Cancer With Local Anesthesia and Early Instillation of Mitomycin C

Abstract

Purpose: We evaluated the results of laser photocoagulation of recurrent low stage noninvasive bladder cancer. Materials and Methods: The study included 36 patients with a recurrent superficial papillary tumor within 1 year of endoscopic resection. Patients underwent laser photocoagulation of the recurrence under local anesthesia and sedation. They received early instillation of 40 mg mitomycin C and were discharged home without a catheter a few hours after the operation. Patients completed a visual analog scale to quantify the perceived level of pain, including 1—no pain to 10—maximum pain. Patients were reviewed after 3, 6 and 12 months to evaluate tumor recurrence. Results: The mean and median visual analog scale score was 3 points (range 1 to 10). No patient had urinary infection or a catheter at hospital discharge. The incidence of recurrence at 12 months was 25%, mainly in the first 15 cases. Conclusions: Laser photocoagulation with local anesthesia and sedation is easy to perform and well tolerated. There were no complications and the recurrence rate was similar to that of transurethral resection, as calculated using the recurrence calculator of the 2006 guidelines on TaT1 (nonmuscle invasive) bladder cancer from the European Association of Urology.